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Complete clinical remission of tumor-stage mycosis fungoides after acute extensive skin necroses, granulomatous reaction, and fever under treatment with bexarotene, vorinostat, and high-dose fenofibrate.
- Source :
-
Journal of the American Academy of Dermatology [J Am Acad Dermatol] 2008 May; Vol. 58 (5 Suppl 1), pp. S88-91. - Publication Year :
- 2008
-
Abstract
- Mycosis fungoides and its variants are a distinct entity with a variable, but well-characterized clinical course. We report on a 51-year-old patient with tumor-stage mycosis fungoides who developed several unusual features such as extensive necrosis of lymphoma lesions, granulomatous reaction, and venular thromboses while under treatment with bexarotene, vorinostat, and high-dose fenofibrate. After surgical removal of skin necroses, the patient recovered and was in complete clinical remission. Possible causal factors such as blastic transformation; hematophagic syndrome; or bacterial, fungal, or viral infection could be excluded. We hypothesize that combination of the high-dose fenofibrate (400 mg) with the retinoid X receptor ligand bexarotene and vorinostat might have induced an increased rate of apoptosis in lymphoma cells in our patient resulting in an extensive release of lymphoma antigens. Augmented antigen release along with changes in local cytokine milieu might have induced macrophage activation and granuloma formation.
- Subjects :
- Acute Disease
Anticarcinogenic Agents administration & dosage
Anticarcinogenic Agents adverse effects
Bexarotene
Biopsy
Drug Eruptions pathology
Female
Fever chemically induced
Granuloma pathology
Humans
Hypolipidemic Agents administration & dosage
Middle Aged
Mycosis Fungoides pathology
Necrosis
Remission Induction
Skin pathology
Skin Neoplasms pathology
Tetrahydronaphthalenes administration & dosage
Vorinostat
Fenofibrate administration & dosage
Granuloma chemically induced
Hydroxamic Acids administration & dosage
Mycosis Fungoides drug therapy
Skin Neoplasms drug therapy
Tetrahydronaphthalenes adverse effects
Subjects
Details
- Language :
- English
- ISSN :
- 1097-6787
- Volume :
- 58
- Issue :
- 5 Suppl 1
- Database :
- MEDLINE
- Journal :
- Journal of the American Academy of Dermatology
- Publication Type :
- Academic Journal
- Accession number :
- 18489056
- Full Text :
- https://doi.org/10.1016/j.jaad.2007.07.012